Among younger adults (those under age 65), 6% who had private insurance skipped medicines to save money, compared to 10% for those with Medicaid and 14% of those with no insurance. Among the poorest adults — those with incomes well below the federal poverty level — nearly 14% did not take medications as prescribed to save money.

This is effecting pharma strategic plans as well. According to Accenture there’s a US$30B affordability gap between 2016-2021 analysts’ sales projections for NME launches and the net budget increases forecast in developed markets. In addition list prices have seen double-digit inflation in the US between 2012-2014, but growth rates are slowing fast and increasingly offset by price discounts.

The average premium for an employer-provided family plan is now $17,545, up from $16,834 last year and from $10,880 in 2005. And workers have been paying a greater share of those premiums. Deductibles, meanwhile, have skyrocketed. The average deductible for all covered workers is $1,280, up 70 percent from 2015.

When it comes to making decisions about their healthcare and the treatments they receive, the three top factors influencing patients’ decisions are:

1ne: The doctor/ physician relationship (66 percent),

2wo: The patient’s ability to maintain their current lifestyle (55 percent).

3hree: Ease of access to the care they’ll need (53 percent).

However, what’s missing from this report by Accenture is that patients are going to balance product outcomes with cost. As one though leader told me “my patients are asking more about cost of medication today than ever before”. “Even with insurance the out of pocket expenses for health care are having a profound impact on patients.”